Infectious Diseases Flashcards
Syphilis features
1-Painless ulcer, sharp border
2- systemic symptoms: fevers, lymphadenopathy
rash on trunk, palms and soles
buccal ‘snail track’ ulcers (30%)
warty lesions on genitalia
3-gummas, cardio and neuro
Tx of syphillis
IM benzathine Penicillin
Features of Hep A
Hepatosplenomegaly
Fatigue
Jaundice
Faecal-oral- shellfish
Dx of chlamydia
NAAT
Causes of cold sores
HSV1
Tx of malaria
Non falciparum- Chloroquine
Mild falciparum- ACT (artesunate + another)
Severe- IV artesunate
when parasite >2%
Tx of TB
Rifampicin- 6m
Isoniazid- 6m
Pyrazidamide-2m
Ethambutol -2m
SE of TB treatment
R- orange
I- peripheral neuropathy- give with pyridoxine
P- Hepato
Ethambutol- visual
Painless ulcer and painful lymphadenopathy
Lymphgranuloma verenum
If progress to proctoclitis- becomes painful
MSM
Mx of lymphgranuloma venerum
Doxyclycline
Painful ulcer and lymph
Haemophilus Ducreyi
Cause of tonsillitis and impetigo
Strep Pyogenes
Sx of typhoid fever
Constipated
Bradycardia
Anorexia
Rose spots
Tx of typhoid fever
Ciproflox
PO azithromycin
Ix of typhoid
Blood culture
Dengue fever Sx
Primary
Headache- retro orbital
Sunburn rash
Secondary
Hypotension
Ix of Dengue
PCR viral antigen
Bulls eye rash
Lyme disease
Organism of lyme disease
Borrella burgdoferi
Mx of lyme
Doxycycline
Rapidly worsening cellulitis with extreme tenderness
Necrotiising fascitis
RF of necrotising fascitits
DM
Skin traum a
SGLT2
Mx of nec fasc
Debridement and Abx
Nec Fascitis in perineum
Fouriners
Tetanus treatment rules
If had 5 doses in <10 years
None required
If >10 years or unsure on vaccines- reinforce vacccine
High risk wound- immunoglobulin
But if had vaccines no need for IG or vaccine
Toxoplasmosis Treatment
No treatment unless immunocomprimised
If you are- pyrimethamine plus sulphadiazine for at least 6 weeks
Tx of toxoplasmosis in HIV/IC
Pyrimethamine plus sulphadiazine 6w
Sx of toxoplasmosis in IC
Cerebral lesions
Headache confusion, drowse
If HIV + and CD4 <200 what is the treatment
Co-trimoxazole
HAART
Ix of HIV
ELISA
If needlestick
p24 antigen and AB testing in 4 weeks and in 3 months
Sx of HIV
Seroconversion- fever, oral ulcers, diarrhoea, sore throat, maculapapular rash
Then AIDS
Mx of HIV
ART- 2x NRTI and either protease inhibitor or NNRTI
Ix for chlamydia and gonorrhoea
Vulvo-vaginal swabs for NAAT
When to send for MSU for UTI
If associated with visible or non visible haematuria
Aged >65
Urine dip is positive in an asymptomatic catheterised patient what do you do
Do not treat
Which pneumonia occurs after influenza
Staph aureus
What can cause false negative Mantoux test
Steroids
Sarcoid
Lymphoma
AIDS
Sx of leptospirosis
Conjunctivitis - subconjunctival haemorrhage
Hepatitis
Work in sewer
Dx with serology
LEP
Legs/liver, eyes
Dx of Hepatitis
Serology
How long after exposure should you test for HIV
4 weeks
If needlestick
p24 antigen and AB testing in 4 weeks and in 3 months
Drug that makes you prone to sunburn
Doxycycline
Tx of schistosomiasis
Praziquantel
Tx of HAP
<5d of admission- Co amox
>5d- tazoscin
Dx of legionella disease
Urinary antigen
Tx of trichomonad vaginalis
Protoza
Metronidazole
Tx of chlamydia in pregnancy
Azithromycin, amoxicillin
First and second line for tx of MRSA
Vancomycin
Linezolid
Hydatid cyst sx
Daughter cysts
Asymptomatic
RUQ pain hepatomegaly
Ix of hydatid cysts
USS
Then CT abdo
Hep B serology
HBsAg- acute infection
HBsAB- previous/vaccinated
HBcAg- chronic
HBcAB- prev infection
Ix for schistosomiasis
Stool and urine culture
Ix of herpes
NAAT
Mx of rabies exposure
Immunoglobins and vaccination
How long should PEP be taken for
28 days
Must be taken before 72 hours
PEP for hepatitis
Hep B- +- vaccine if responder, globing and vaccine if non
C- monthly PCR
Bloody diarrhoea and liver abcess
Entamoeba histolytica
What to do if immunocompromised and exposed to varicella
Send for antibodies
If no- VZIG
Tx of Lyme
Grasp tick as close to skin
Doxy only if symptomatic
HIV seroconversion
3-12 weeks
Flu like symptoms
Leishmaniasis sx
Return from south/Central America
Ulcers
Live attenuated vaccines
BUMPY
BCG
Typhoid
MMR
Polio oral
Yellow fever
Tx of Jarish herxheimer reaction
Paracetamol
Orchitis testing
NAAT- younger STI
Older- MSU- married and 50 only partner
Organism in older orchitis
E coli
Syphilis testing
Non treponemal- not that specific
Treponemal- specific
So if + non and neg specific- false positive
Tx of gonnorhea if dont want needles
Cefixime and azithromycin
BV organism
Gardnerella vaginalis
Organism causing chronic wound infections
Pseudomonas aeruginosa
MRSA tx
Vancomycin
Tx of bacterial meningitis >50
Cef + amox
When does PCP occur in HIV
CD4 <200
Visualisiation of crytpococus
India ink
If tetanus sx
Give IM IG
When should syphillus reinfection be treated
If RPR rises by 4x
Features suggestive of gas gangrene
Bubbles in tissue in x ray
Crepitus
Foul smelling
C perfringens
Features of each stage of syphillis
Primary- painless ulcer
Secondary- systemic- fevers, rash on trunk, warts on genitalia
Tertiary- gummas- granulomas on skin/bones, Ascending AA, paralysis
Ix of latent TB
Mantoux test
Erysipleas tx
FLuclox
Men with suspected UTI tx order
MSU before ABx
Then ABx 7 d
Complications of gonnorheoa
Males- urethral stricture
Females- PID, bartholin abcess
If skin peeling on palms and soles, hypotensive, fever
Staph toxic shock syndrome
Maybe says started period in last couple of days
Cause of false negative mantoux
Sarcoid
Lymphoma
AIDS
Steroids
Toxoid vaccines
Diptheria
Rabies
Tetanus
Inactivated vaccines
Influenza
Hep A
Rabies
Vaccine for IVDU
Hep B
Vaccine for those spending time with people who live in Asia
BCG
Infection causing pain, bloating and floating stools
Giardia
Resolves in 2-5 weeks
Malabsorption of Vit A, B12, iron, lipids
Hep genetics
All RNA apart from Hep B
What needs to be measured before starting terbinafine
LFTs
What needs to be measured before starting RIPE
U+E, LFT, vision, FBC
Best way to assess response to Hep C tx
Viral load
Test for eradication of H pylori
Urea Breath test
What can C diff cause
Toxic megacolon
Vaccines for hep
A and b
None for c d e
Ix of Lyme disease
Antibody titre
Cause of Kaposi sarcoma
HHV 8
Fever, spasm, dysphagia, IVDU
Tetanus
Most common cause of diarrhoea in HIV
Crytosporidium
Sx of Lyme disease
FACE
Facial palsy
Arthritis
Carditis
Erythema migrans
Most common organism for central line infections
Staph epidermis
Common SE of vancomycin and what to do
Red man syndrome- flushed
Stop it until sx stopped and then re start
Clumsiness and irritable with low CD4 and PML shown
JC virus
HPV causing cervical cancer
16, 18
Disseminated gonnorheoa sx
Tenosynovitis
Polyarthritis
Dermatitis
Grey membrane on tonsils
Diptheria
Tx of MRSA if positive on screening swab
Nasal mupirocin and chlorhexidine
Mx of campylobacter
Usually self limiting
Clarithromycin is severe
Cellulitis in pregnancy with penicillin allergy
Erythromycin
Viral meningitis causes
Coxsackievirus
Examples of HIV drugs
NRTI- zidovudine, tenoforvir
Protease- navir is a pro
Gravir- interphase
If diagnosed with TB what further test should you do on them
HIV
If treponema test positive and non treponomal negative what is the dx
Successful treated syphillis
Tx of genital warts
Multiple non keratinised- topical podophyllum
Solitary keritonised- cryotherapy
What causes genital warts
HPV 6+11
Most appropriate Ix for lyme disease
Blood test for serology
ELISA
Tx of sinusitis with fever and high HR
Phenoxymethylpenicillin
Tx of prostatitis and pyelo
Prostatitis- Quinilone cirpo or trimethoprim
Pyelo- Cef or quinilones- cirpo
Severe cellulitis tx or near eye/nose
Co amox
Dx of strep vs EBV
Monospot- EBV
Anti Strep O titre- Strep
Tx of chlamydia in pregnancy with penicillin allergy
Erythromycin
Recurrent UTIs following sexual intercourse tx
Prophylactic abs after sex
Usual treatment of bloody diarrhoea and fever
Cipro
Causes of false positive syphillis
with Syphillis Sometimes mistakes happen
SLE, TB, malaria, HIV
Chagas disease
South America trip
Trypanosoma chancre - painless subcutaneous nodule at site of infection
intermittent fever
enlargement of posterior cervical lymph nodes
Must do ECG for myopathy
Tx of ameobasis
Metronidazole
Yellow fever sx
Ill initially - brief remission in between
Jaundice
Bradycardia
High fevers
Growth of gram positive in chains
Strep pyogenes
Infection that doesn’t get Better with correct AB
Abscess or collection
Giadia vs amoeba vs pyogenic liver abcess
Giardia- long incubation, steathorrea, no liver abcess
Amoeba- liver abcess, diarrhoea
Pyogenic- abcess, no diarrhoea
Gonorrheoa and chlamydia negative but purulent penile discharge dx
Mycoplasm genitalia
If on doxorubicin/cyclo and fever what should you do
Treat for neut sepsis
IV tazoscin
IVDU with lymphadenopathy, pharyngeal oedema, erythema on floor of mouth and stridor
Ludwig angina
Cellulitis of floor of mouth
Mens with UTI mx
MSU and Nitro 7d
Sx of malaria
Severe- >2% on film
Cyclical fevers- falci- 48 hours so 1 day off fever, AFRICA
Jaundice
Anaemia
Neuro involvement
non falciparium- Asia, cyclical fever
P malaria- 2 days off fever